Letter

Interventions to treat shoulder pain

BMJ 1998; 316 doi: 10.1136/bmj.316.7145.1676a (Published 30 May 1998)
Cite this as: BMJ 1998;316:1676.2

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Review was overly negative

  1. Bela Szebenyi, Consultant rheumatologist,
  2. Paul Dieppe, Director
  1. National Institute of Rheumatology and Physiotherapy, H-1525, Budapest 114, Hungary
  2. Medical Research Council Health Services Research Collaboration, University of Bristol, Bristol BS8 2PR
  3. Department of Rheumatology, Queen Mary's Hospital, Kent DA14 6LT
  4. Department of Epidemiology and Preventive Medicine, Monash University, Melbourne 3186, Australia
  5. Family and Community Medicine, Preventive Medicine and Biostatistics, University of Toronto, Ontario, Canada

    EDITOR—The systematic review by Green and colleagues of interventions for treating shoulder pain concluded that there is little evidence to support the use of any of the common interventions for the management of shoulder pain.1 This is a negative message that is likely to inhibit practitioners from treating patients with shoulder pain and to dissuade them from referring these patients to specialists. While we agree with the other conclusions of the study, we disagree with the negative message about treatment for several reasons.

    Rheumatologists make decisions about the treatment of musculoskeletal disorders such as shoulder pain based on the duration of the condition, its severity, and a careful examination to define the exact site of the lesion.2 It is generally taught, for example, that the injection of corticosteroids will only work if done soon after the onset of any shoulder disorder and if the injection has been precisely localised to the anatomical site of the problem, such as a specific tendon or bursa within the rotator cuff.3 In the systematic review of the evidence great weight was given …

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